17.2 FDA-Approved Medication Guide

MEDICATION GUIDE

ESCITALOPRAM TABLETS, USP

(es" sye tal' oh pram)

5 mg, 10 mg and 20 mg

Read the Medication Guide that comes with Escitalopram tablets, USP tablets before you start taking it and each time you get a refill. There may be new information. This Medication Guide does not take the place of talking to your healthcare provider about your medical condition or treatment. Talk with your healthcare provider if there is something you do not understand or want to learn more about.

What is the most important information I should know about escitalopram tablets, USP tablets?

Escitalopram tablets, USP tablets and other antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment or when the dose is changed.

Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions.

Watch for these changes and call your healthcare provider right away if you notice:

New or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe.

Pay particular attention to such changes when escitalopram tablets, USP tablets are started or when the dose is changed.

Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.

Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency, especially if they are new, worse, or worry you:

attempts to commit suicide

acting on dangerous impulses

acting aggressive or violent

thoughts about suicide or dying

new or worse depression

new or worse anxiety or panic attacks

feeling agitated, restless, angry or irritable

trouble sleeping

an increase in activity or talking more than what is normal for you

other unusual changes in behavior or mood

Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency. Escitalopram tablets, USP tablets may be associated with these serious side effects:

2. Serotonin Syndrome. This condition can be life-threatening and may include:

agitation, hallucinations, coma or other changes in mental status

coordination problems or muscle twitching (overactive reflexes)

racing heartbeat, high or low blood pressure

sweating or fever

nausea, vomiting, or diarrhea

muscle rigidity

3. Severe allergic reactions:

trouble breathing

swelling of the face, tongue, eyes or mouth

rash, itchy welts (hives) or blisters, alone or with fever or joint pain

4. Abnormal bleeding: Escitalopram tablets, USP tablets and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin®*, Jantoven®*), a non-steroidal anti-inflammatory drug (NSAIDs, like ibuprofen or naproxen), or aspirin.

5. Seizures or convulsions

6. Manic episodes:

greatly increased energy

severe trouble sleeping

racing thoughts

reckless behavior

unusually grand ideas

excessive happiness or irritability

talking more or faster than usual

7. Changes in appetite or weight. Children and adolescents should have height and weight monitored during treatment.

8. Low salt (sodium) levels in the blood. Elderly people may be at greater risk for this. Symptoms may include:

headache

weakness or feeling unsteady

confusion, problems concentrating or thinking or memory problems

9. Visual problems

eye pain

changes in vision

swelling or redness in or around the eye

Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.

anxiety, irritability, high or low mood, feeling restless or changes in sleep habits

headache, sweating, nausea, dizziness

electric shock-like sensations, shaking, confusion

What are Escitalopram Tablets, USP ?

Escitalopram tablets, USP are a prescription medicine used to treat depression. It is important to talk with your healthcare provider about the risks of treating depression and also the risks of not treating it. You should discuss all treatment choices with your healthcare provider. Escitalopram tablets, USP are also used to treat:

Major Depressive Disorder (MDD)

Generalized Anxiety Disorder (GAD)

Talk to your healthcare provider if you do not think that your condition is getting better with escitalopram tablets, USP treatment.

Who should not take escitalopram tablets, USP ?

Do not take escitalopram tablets, USP if you:

are allergic to escitalopram tablets, USP or citalopram hydrobromide or any of the ingredients in escitalopram tablets, USP tablets. See the end of this Medication Guide for a complete list of ingredients in escitalopram tablets, USP tablets.

take a Monoamine Oxidase Inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid.

Do not take an MAOI within 14 days of stopping escitalopram tablets, USP .

Do not start Escitalopram Tablets if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your physician.

People who take escitalopram tablets, USP close in time to an MAOI may have serious or even life-threatening side effects. Get medical help right away if you have any of these symptoms:

high fever

uncontrolled muscle spasms

stiff muscles

rapid changes in heart rate or blood pressure

confusion

loss of consciousness (pass out)

take the antipsychotic medicine pimozide (Orap®*) because taking this drug with escitalopram tablets, USP can cause serious heart problems.

What should I tell my healthcare provider before taking escitalopram tablets, USP ? Ask if you are not sure.

are pregnant or plan to become pregnant. It is not known if escitalopram tablets, USP tablets will harm your unborn baby. Talk to your healthcare provider about the benefits and risks of treating depression during pregnancy

are breast-feeding or plan to breast-feed. Some escitalopram tablets, USP may pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby while taking escitalopram tablets, USP tablets.

Tell your healthcare provider about all the medicines that you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Escitalopram tablets, USP and some medicines may interact with each other, may not work as well, or may cause serious side effects.

Your healthcare provider or pharmacist can tell you if it is safe to take escitalopram tablets, USP with your other medicines. Do not start or stop any medicine while taking escitalopram tablets, USP without talking to your healthcare provider first.

If you take escitalopram tablets, USP, you should not take any other medicines that contain escitalopram tablets, USP or citalopram hydrobromide including: Celexa*.

How should I take escitalopram tablets, USP ?

Take escitalopram tablets, USP exactly as prescribed. Your healthcare provider may need to change the dose of escitalopram tablets, USP until it is the right dose for you.

Escitalopram tablets, USP may be taken with or without food.

If you miss a dose of escitalopram tablets, USP , take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of escitalopram tablets, USP tablets at the same time.

If you take too many escitalopram tablets, USP , call your healthcare provider or poison control center right away, or get emergency treatment.

What should I avoid while taking escitalopram tablets, USP tablets?

Escitalopram tablets, USP tablets can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how escitalopram tablets, USP tablets affect you. Do not drink alcohol while using escitalopram tablets, USP.

What are the possible side effects of escitalopram tablets, USP?

Escitalopram tablets, USP tablets may cause serious side effects, including all of those described in the section entitled What is the most important information I should know about escitalopram tablets, USP ?

Common possible side effects in people who take escitalopram tablets, USP include:

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of escitalopram tablets, USP tablets. For more information, ask your healthcare provider or pharmacist.

CALL YOUR DOCTOR FOR MEDICAL ADVICE ABOUT SIDE EFFECTS. YOU MAY REPORT SIDE EFFECTS TO THE FDA AT 1-800-FDA-1088.

Keep escitalopram tablets, USP and all medicines out of the reach of children.

General information about escitalopram tablets, USP

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use escitalopram tablets, USP for a condition for which it was not prescribed. Do not give escitalopram tablets, USP to other people, even if they have the same condition. It may harm them.

This Medication Guide summarizes the most important information about escitalopram tablets, USP. If you would like more information, talk with your healthcare provider. You may ask your healthcare provider or pharmacist for information about escitalopram tablets, USP that is written for healthcare professionals.

For more information about escitalopram tablets, USP , call STI Pharma at 1-888-301-9680